M30B48 Professional Skills

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M30B48 Professional Skills

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M30B48 Professional Skills

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Course Code: M30B48
University: University Of The West Of England

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Country: United Kingdom

Question:
In June 2018, the former health minister, Jeremy Hunt, apologised to the families of 456 patients who had lost their lives due to medical malpractice at Gosport War Memorial Hospital in the 1990s. The 456 elderly patients were given opioid drugs which resulted in them losing their lives. The opioids were prescribed by Dr Jane Barton throughout the 1990s. Consultants knew about the practice but did not intervene. Nurses and pharmacists also knew that something was not right, but did as they were instructed to do. In 1991, senior nurses brought the matter to the attention of the Royal College of Nursing but were advised not to take the matter any further.

In 2009, Dr Barton was brought before the General Medical Council (GMC) facing disciplinary action. She was found guilty of serious professional misconduct however she was not struck off the register, though she retired soon after. The families of those who died have been fighting for over 20 years to bring the doctor – and those who did not stop her – to justice by facing criminal charges.
To what extent has the situation described in the case study damaged the reputation of the organisation?
What can the organisation do to rebuild their reputation?

Answer:

Introduction:
Organizational reputation refers to the estimation that the stakeholders have on the basis of past actions along with probability of the future behaviour. The reputation that an organization has can enjoy an organization in performing well. In the year 2018, health minister apologised to families who lost the lives owing to the malpractice that was carried out at Gosport War Memorial Hospital in 1990 (Theguardian.com 2018).  The non-intervention by the consultants proved to be disastrous for the reputation of organization. This report describes in detail how the incident that took place at Gosport War Memorial Hospital was instrumental in damaging reputation of organization. The report also throws light on the recommendations that can help the organization in rebuilding reputation.
Overview of the Incident
An incident that shook the faith of the people on health care and nursing homes was the Gosport War Memorial incident that took place in the year 1990. On the basis of the report, it was found that 450 elderly people had lost their life owing to opioid drugs that shortened their life. The patients did not need the drugs and the administration of the medicine in heavy dose proved to be fatal for the patients in the war memorial hospital. There occurred 1500 deaths at that of the hospital and around 456 people died owing to inappropriate administration. It was brought out with the help of report that Dr Jane Barton who was working as clinical assistant had routinely indulged in overprescribing drugs for the patients that cost the lives of the patients (Independent.co.uk 2018).  There were consultants who knew about her actions but there was no intervention that proved to be disastrous for the health of the patient. The nurses along with the pharmacists had also collaborated in giving high level of the drugs that they must have known was not appropriate for the health of the patient.
There were some senior nurses who had in the year 1991 raised alarm pertaining to the using of diamorphine. It is a medical term of that of heroin for the patients who were not suffering from any kind of pain. It was administered when a syringe-driver pumped out the doses that could not adjust to the needs of the patient. There was a staff meeting which was attended by that of a convenor from that of Royal College of Nursing (Bbc.com 2018).  The nurses were given warning and asked not to take the matter further. It was stated by the report that they had provided the hospital with the opportunity of rectifying overprescribing. Handing the loved ones to the hospital is indicative of an act of trust and the hospitals in treating the patients well can help in retaining faith in the heart of the consumers (Mirror.co.uk 2018).  The hospitals in the event of taking the life of the patients for granted violates the faith the family members of the patients have that results in jeopardizing the life of the patient. This kind of violation creates distrust in the minds of the patients. It can shatter the confidence that the patients have on the healthcare system and this kind of act threatens the health of the patient. It is instrumental in causing mental turbulence in the mind of the patient along with his family members.
The situation has destroyed reputation of the organization and it has destroyed the prestige that the hospital used to enjoy in the industry. This kind of destroying of reputation makes the patients who would go to the hospital in the future think twice before admitting the patients in the hospital. The diamorphine was major life-shortening opioid drug that was attached to back of patient (Telegraph.co.uk 2018).  Opioid drugs were mainly used for relieving the pain of the patient. It was brought out with the help of report that in the 456 cases there was no kind of evidence that the administration of opioid was justified. Anticipatory prescribing helps in ensuring that the patients get the pain relief in the event of the patients needing it. The records that were brought out in relation to Gosport Hospital showed that showed the drugs were given in “wide dose range” which threatened the health of the patient.
The reputation of Gosport War Memorial Hospital was questioned owing to the fact that use of the diamorphine was brought into attention of branch convenor of that of Royal College of Nursing. The nursing staff of that of Redclyffe Annexe had raised concerns in relation to the using of diamorphine with the manager of that Gosport Hospital. It was being stated that all the patients who had been provided with diamorphine did not have pain (Darbyshire, Thompson and Watson 2018).  The hospital had not considered about the other form of analgesia and the drug regime was not on the basis of needs of the patient. The deaths at the Gosport War Memorial Hospital was hastened unnecessarily due to the wrong administration of drugs by the hospital. The situation hence dampened reputation of organization and it was a blot on the reputation of the hospital.
Dr Barton initially was initially responsible for the patients who were working at the Redclyffe Annexe. From the year 1993, Dr Barton had stopped to take responsibility for the Redclyffe Annexe. She was later on asked to take responsibility for Dryad along with Daedalus ward within the new hospital. 44 beds hence came under the care of Dr Barton and she was kept in charge of rehabilitation (Weatherley, Bashir and Karia 2018). The CHI Review that was conducted brought out the fact that there existed lack of the clarity among the various groups of the staff. This resulted into confusion and proper communication was not carried out that severely cost lives of the patients. The review carried out brought to the fore the fact that the lack of adequate checking mechanism proved to be catastrophic for the reputation of the hospital.
Recommendations for Gosport War Memorial Hospital
The organization can take certain steps that can help them in rebuilding their reputation. The hospital can start working in a new manner that can help them in reviving their lost glory. The hospital can make the families of the patients engage in various process that can be instrumental in solving issues related to wrong administration of drugs. The complainants should be provided with the opportunity of meeting the authorities at the hospital and address their grievances that can help in improving the quality of service at Gosport War Memorial Hospital. The hospital can take recourse to a project that can help them in communicating in timely manner with the family of the patients that can help in improving kind of the service that is provided at the hospital (Gibbons and Bourne 2016). This process can prove to be of great use in investigating concerns about the patients who lack the voice in relation to the different processes at the hospital.
The hospital can make use of Employer Liaison Service adviser that can help in building strong relationship with the employers. It can be of great use in advising the people that can help in improving local intelligence in relation to issues along with individuals. The Service advisers can be taken recourse to that can help in supporting local process that would be in the interest of the patient along with the healthcare provider. The hospital should also take the help of Office Liaison Advisor and it should be done in partnership with that of medical schools along with health care regulator (Honey 2017). The hospital should liaise directly with the police forces so that they can understand early about any doctor who has come under the focus of the police investigations. These kinds of cases should be reviewed at regular interval by the senior members of the staff that can help in taking care of the patients in the hospital. In the event of patient safety risk being posed by the doctor the hospital should act very swiftly so that he can apply for the action with the help of Medical Practitioner’s Tribunal Services. The Section 35 A should be used by the hospital in a pro-active manner that can help in the proper enforcing of laws within the hospital (Hannington 2016). These kind of power can help the companies in supplying information or producing a document that can prove to be relevant fir the enquiries in providing information.
The hospital would ask for written evidence from the employers that can help in providing information that would be relevant to investigation. The hospital should work with the various other organisations in the system like the professional along with the system regulators that can help in sharing information in relation to emerging concerns in relation to health care system in a robust manner. The hospital can make use of Emerging Concerns Protocol that can strengthen the ability of the hospital in acting in a co-ordinated manner (Potgieter and Doubell 2018). This can help in pointing out the risk pertaining to patients along with the families.  This can help in preventing harm to the health of the patients and they should prioritise activity in the event of needing rapid action.
The doctors should be entrusted with the professional responsibility so that they can act on the concerns. The managers responsibility should be highlighted that can help in taking care of the fact that systems have been kept in place that can help in raising concerns. The hospital should instruct external counsel in advising the hospital on important matters that can help the hospital in successfully dealing with the important issues that are raised in the hospital. The institutions of the hospitals should have mechanisms that can help in medication reconciliation when the patients are transferred from that of one institution to that of the next. The medication should be verified and the nurses should compare the medication to that of medication administration record that can help in offering the right dose of medicine to the patient.
Patients can take care of the fact that they are making use of prescription medication by following of the directions that has been given on label of a medicine. The physicians along with the patients in the hospital should be provided with proper education that can help the organisation in re-building reputation. The hospital should carry out initial assessment of patient and the patients at the hospital should be regularly monitored that can help in prevention of opioid drug misuse at the hospital. It can be said that opioid treatment contract should be established and there should be written commitment in between the doctor and the patient stipulating terms of the treatment which can help hospital in building up their reputation. The patients at the hospital should be given health information in relation to safe opioid use that can help in preventing these kinds of incident at the hospital.
Conclusion:
The reputation that an organization has can help it in winning the confidence of the people and it can help an organization in making profits. The incident that gravely shook health of the people was the opioid misuse at took place at Gosport War Memorial Hospital. Opioid drug caused 450 elderly people to lose life. Dr Jane Barton was responsible for overprescribing the drugs which led many patients to lose their lives. The hospital can take recourse to some measures that can help it in regaining faith of the people. Hospitals can actively engage families of the patients that can solve the issues pertaining to misuse of the drugs. Hospital can take the help of Employer Liaison Service which can help the hospital in building proper relationship with employers. It can prove to be of use in improving the aspect of local intelligence pertaining to various issues. Hospital can carry out work with the other organisations like system regulator which can be of help in sharing information pertaining to the concerns in health care system. The patients should be provided with health information pertaining to the safe usage of opioid which can prevent these incidents at hospital.
References:
Bbc.com (2018). Gosport: The numbers behind the scandal. [online] BBC News. Available at: https://www.bbc.com/news/uk-england-44574899 [Accessed 12 Dec. 2018].
Darbyshire, P., Thompson, D.R. and Watson, R., 2018. Nursing schools: dumbing down or reaching up?. Journal of nursing management.
Gibbons, H. and Bourne, R.R., 2016. Extending a nurse practitioner’s role to undertake advanced procedures. Listening, 7, p.00.
Hannington, T., 2016. How to measure and manage your corporate reputation. Routledge.
Honey, G., 2017. A short guide to reputation risk. Routledge.
Independent.co.uk (2018). GP accused of being responsible ‘for at least 92 deaths’ faces calls for criminal charges. [online] The Independent. Available at: https://www.independent.co.uk/news/health/gosport-war-memorial-hospital-deaths-scandal-jane-barton-shipman-a8406456.html [Accessed 12 Dec. 2018].
Mirror.co.uk (2018). Up to 650 hospital patients’ lives shortened by opioids regime, report finds. [online] mirror. Available at: https://www.mirror.co.uk/news/uk-news/breaking-least-450-patients-lives-12749435 [Accessed 12 Dec. 2018].
Potgieter, A. and Doubell, M., 2018. Employer branding as a strategic corporate reputation management tool. African Journal of Business and Economic Research, 13(1), pp.135-155.
Telegraph.co.uk (2018). Gosport inquiry panel accused of “NHS cover up” over faulty syringe drivers. [online] The Telegraph. Available at: https://www.telegraph.co.uk/news/2018/06/23/gosport-inquiry-panel-accused-nhs-cover-faulty-syringe-drivers/ [Accessed 12 Dec. 2018].
Theguardian.com (2018). Gosport hospital: more than 450 patients died due to opioid drugs policy. [online] the Guardian. Available at: https://www.theguardian.com/society/2018/jun/20/gosport-war-memorial-hospital-opioid-drugs-policy-inquiry [Accessed 12 Dec. 2018].
Weatherley, A., Bashir, S. and Karia, R., 2018. Improving and standardising the management of controlled drugs. Management, 16, p.48.

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